Malignant colorectal obstruction: treatment with a flexible covered stent.
OBJECTIVE
To evaluate the usefulness of flexible covered stents for treatment of acute colorectal obstruction secondary to malignant colorectal carcinoma.


METHODS
Twenty patients with acute colorectal obstruction secondary to malignant colorectal carcinoma were treated by means of intubation of a flexible stent with fluoroscopic guidance with occasional endoscopic assistance. Two types of stents were placed (type 1, completely covered, type 2, two-thirds of proximal part uncovered). Of 15 patients with primary colorectal carcinoma, 12 underwent placement of a stent for presurgical decompression of colorectal obstruction; three, for palliative decompression. In three patients with rectosigmoid seeding from advanced gastric carcinoma and two patients with recurrent colonic carcinoma, stents were placed for palliative decompression.


RESULTS
Stent placement was successful in 18 (90%) of 20 patients. Symptoms of obstruction resolved within 24 hours in 15 (75%) patients. Eight patients underwent elective single-stage surgery without complications 5-7 days after stent placement. Two patients underwent tumor resection and colostomy. In eight patients, stents provided palliative decompression of the colon. Type 1 stents migrated in four (50%) of eight patients; type 2 stents were used thereafter.


CONCLUSIONS
Flexible stents effectively relieved acute colonic obstruction secondary to malignant rectosigmoid neoplasm. Stent placement allowed patients to undergo single-stage surgery in most cases and provided palliative decompression in cases of inoperable or disseminated disease.
Choo
I W
IW
Department of Radiology, College of Medicine, Sung Kyun Kwan University, Samsung Medical Center, Kangnam-ku, Seoul, Korea.
Do
Y S
YS
Suh
S W
SW
Chun
H K
HK
Choo
S W
SW
Park
H S
HS
Kang
S K
SK
Kim
S K
SK
D000208:Acute Disease; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000150:complications*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D011140:Polyurethanes; D011446:Prospective Studies; D011859:Radiography; D012002:Rectal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D011140:Polyurethanes